Saturday, March 30, 2013

WASHINGTON (AP) — Veterans groups are rallying to fight any proposal to change disability payments as the federal government attempts to address its long-term debt problem. They say they've sacrificed already.

Government benefits are adjusted according to inflation, and President Barack Obama has endorsed using a slightly different measure of inflation to calculate Social Security benefits. Benefits would still grow but at a slower rate.

Advocates for the nation's 22 million veterans fear that the alternative inflation measure would also apply to disability payments to nearly 4 million veterans as well as pension payments for an additional 500,000 low-income veterans and surviving families.

"I think veterans have already paid their fair share to support this nation," said the American Legion's Louis Celli. "They've paid it in lower wages while serving, they've paid it through their wounds and sacrifices on the battlefield and they're paying it now as they try to recover from those wounds."

Economists generally agree that projected long-term debt increases stemming largely from the growth in federal health care programs pose a threat to the country's economic competitiveness. Addressing the threat means difficult decisions for lawmakers and pain for many constituents in the decades ahead.

But the veterans' groups point out that their members bore the burden of a decade of war in Iraq and Afghanistan. In the past month, they've held news conferences on Capitol Hill and raised the issue in meetings with lawmakers and their staffs. They'll be closely watching the unveiling of the president's budget next month to see whether he continues to recommend the change.

Obama and others support changing the benefit calculations to a variation of the Consumer Price Index, a measure called "chained CPI." The conventional CPI measures changes in retail prices of a constant marketbasket of goods and services. Chained CPI considers changes in the quantity of goods purchased as well as the prices of those goods. If the price of steak goes up, for example, many consumers will buy more chicken, a cheaper alternative to steak, rather than buying less steak or going without meat.

Supporters argue that chained CPI is a truer indication of inflation because it measures changes in consumer behavior. It also tends to be less than the conventional CPI, which would impact how cost-of-living raises are computed.

Under the current inflation update, monthly disability and pension payments increased 1.7 percent this year. Under chained CPI, those payments would have increased 1.4 percent.

The Congressional Budget Office projects that moving to chained CPI would trim the deficit by nearly $340 billion over the next decade. About two-thirds of the deficit closing would come from less spending and the other third would come from additional revenue because of adjustments that tax brackets would undergo.

Isabel Sawhill, a senior fellow in economic studies at The Brookings Institution, a Washington-based think tank, said she understands why veterans, senior citizens and others have come out against the change, but she believes it's necessary.

"We are in an era where benefits are going to be reduced and revenues are going to rise. There's just no way around that. We're on an unsustainable fiscal course," Sawhill said. "Dealing with it is going to be painful, and the American public has not yet accepted that. As long as every group keeps saying, 'I need a carve-out, I need an exception,' this is not going to work."

Sawhill argued that making changes now will actually make it easier for veterans in the long run.

"The longer we wait to make these changes, the worse the hole we'll be in and the more draconian the cuts will have to be," she said.

That's not the way Sen. Bernie Sanders sees it. The chairman of the Senate Committee on Veterans' Affairs said he recently warned Obama that every veterans group he knows of has come out strongly against changing the benefit calculations for disability benefits and pensions by using chained CPI.

"I don't believe the American people want to see our budget balanced on the backs of disabled veterans. It's especially absurd for the White House, which has been quite generous in terms of funding for the VA," said Sanders, I-Vt. "Why they now want to do this, I just don't understand."

Sanders succeeded in getting the Senate to approve an amendment last week against changing how the cost-of-living increases are calculated, but the vote was largely symbolic. Lawmakers would still have a decision to make if moving to chained CPI were to be included as part of a bargain on taxes and spending.

Sanders' counterpart on the House side, Rep. Jeff Miller, R-Fla., the chairman of the House Committee on Veterans' Affairs, appears at least open to the idea of going to chained CPI.

"My first priority is ensuring that America's more than 20 million veterans receive the care and benefits they have earned, but with a national debt fast approaching $17 trillion, Washington's fiscal irresponsibility may threaten the very provision of veterans' benefits," Miller said. "Achieving a balanced budget and reducing our national debt will help us keep the promises America has made to those who have worn the uniform, and I am committed to working with Democrats and Republicans to do just that."

Marshall Archer, 30, a former Marine Corps corporal who served two stints in Iraq, has a unique perspective about the impact of slowing the growth of veterans' benefits. He collects disability payments to compensate him for damaged knees and shoulders as well as post-traumatic stress disorder. He also works as a veterans' liaison for the city of Portland, Maine, helping some 200 low-income veterans find housing.

Archer notes that on a personal level, the reduction in future disability payments would also be accompanied down the road by a smaller Social Security check when he retires. That means he would take a double hit to his income.

"We all volunteered to serve, so we all volunteered to sacrifice," he said. "I don't believe that you should ever ask those who have already volunteered to sacrifice to then sacrifice again."

That said, Archer indicated he would be willing to "chip in" if he believes that everyone is required to give as well.

He said he's more worried about the veterans he's trying to help find a place to sleep. About a third of his clients rely on VA pension payments averaging just over $1,000 a month. He said their VA pension allows them to pay rent, heat their home and buy groceries, but that's about it.

"This policy, if it ever went into effect, would actually place those already in poverty in even more poverty," Archer said.

The changes that would occur by using the slower inflation calculation seem modest at first. For a veteran with no dependents who has a 60 percent disability rating, the use of chained CPI this year would have lowered the veteran's monthly payments by $3 a month. Instead of getting $1,026 a month, the veteran would have received $1,023.
Raymond Kelly, legislative director for Veterans of Foreign Wars, acknowledged that veterans would see little change in their income during the first few years of the change. But even a $36 hit over the course of a year is "huge" for many of the disabled veterans living on the edge, he said.

The amount lost over time becomes more substantial as the years go by. Sanders said that a veteran with a 100 percent disability rating who begins getting payments at age 30 would see their annual payments trimmed by more than $2,300 a year when they turn 55.

Health and Human Services (HHS) Secretary Kathleen Sebelius today announced a final rule with a request for comments that provides, effective January 1, 2014, the federal government will pay 100 percent of the cost of certain newly eligible adult Medicaid beneficiaries. These payments will be in effect through 2016, phasing down to a permanent 90 percent matching rate by 2020. The Affordable Care Act authorizes states to expand Medicaid to adult Americans under age 65 with income of up to 133 percent of the federal poverty level (approximately $15,000 for a single adult in 2012) and provides unprecedented federal funding for these states.

“This is a great deal for states and great news for Americans,” HHS Secretary Kathleen Sebelius said. “Thanks to the Affordable Care Act, more Americans will have access to health coverage and the federal government will cover a vast majority of the cost. Treating people who don’t have insurance coverage raises health care costs for hospitals, people with insurance, and state budgets.”

Today’s final rule provides important information to states that expand Medicaid. It describes the simple and accurate method states will use to claim the matching rate that is available for Medicaid expenditures of individuals with incomes up to 133 percent of poverty and who are defined as “newly eligible” and are enrolled in the new eligibility group. The system is set up to make eligibility determinations as simple and accurate as possible for state programs.

Under the Affordable Care Act, states that cover the new adult group in Medicaid will have 100 percent of the costs of newly eligible Americans paid for by the federal government in 2014, 2015, and 2016. The federal government’s contribution is then phased-down gradually to 90 percent by 2020, and remains there permanently. For states that had coverage expansions in effect prior to enactment of the Affordable Care Act, the rule also provides information about the availability of an increased FMAP for certain adults who are not newly eligible.

The rule builds on several years of work that HHS has done to support and provide flexibility to states’ Medicaid programs ahead of the 2014 expansion, including:

90 percent matching rate for states to improve eligibility and enrollment systems;

More resources and flexibility for states to test innovative ways of delivering care through Medicaid;

More collaboration with states on audits that track down fraud; and

Specifically outlining ways states can make Medicaid improvements without going through a waiver process.

PARIS (AP) - Steven Coppens had already spent most of his lifetime battling illness before his autoimmune disease took yet another toll seven years ago, leaving him in a wheelchair.

But, the 31-year-old Belgian says in a gravelly voice, he's still the man he once was, and he has the same desires as anyone in the prime of life.

"In the beginning I had to adapt to life in a wheelchair. And over the first years, sex came second. But after a while, it does come back," said Coppens, who lives about 30 kilometers (20 miles) outside Brussels.

That was when he went looking for escorts on the Internet.

"Those girls show up and you realize they have a problem with this and are scared off. And at this point, I'm not even talking about the prices they ask for," he said. "Just imagine that for some reason you cannot have a girl. You keep on looking. A man in a wheelchair still has the same sexual drive."

Coppens now volunteers with Aditi, a Belgian organization dedicated to helping the disabled in their search for sexual fulfillment. And he supports the use of "sex surrogates" - people who are paid specifically to help disabled people explore their sexuality.

Belgian law often leaves the sale of sex in a legal gray area, allowing for some sexual services for people with severe disabilities. In neighboring France, however, a tense debate on the topic is just beginning.

The question came up after an official near Paris called for allowing sex assistants as part of the publicly funded social services offered to those, he said, who were least able to "discover their sexuality and their bodies."

The Socialist politician, Jerome Guedj, pulled the most contentious proposal Monday, just ahead of the vote in the local council, removing the term "sex surrogates" after coming under criticism for opening the door to legalized prostitution. Instead, the council agreed for now to open a "reflection on the sexual life of the disabled."

It wasn't what activists for France's disabled community were hoping for.

"Sexuality doesn't take disability into consideration. It's in human nature," said Pascale Ribes, vice president of the French Association for the Paralyzed, which has pressed for state approval for sexual assistance. "There are people who are deprived of access to their bodies, of their sexuality. Some can handle abstinence, but to be abstinent without choosing it is terrible."

The national ethics council, however, has recommended against sex assistants and says such a move risks "merchandising the human body."

Guedj, head of the Essonne department south of Paris, noted that sex surrogates for the disabled are permitted in other European countries as well as in the U.S., as seen in the recent film "The Sessions," which was inspired by an essay by Mark O'Brien, an American writer who contracted polio as a child and used an iron lung and a reclined wheelchair for rest of his life.

"Why do rehabilitation hospitals teach disabled people how to sew wallets and cook from a wheelchair but not deal with a person's damaged self-image? Why don't these hospitals teach disabled people how to love and be loved through sex, or how to love our unusual bodies," O'Brian wrote in his 1990 essay, "On Seeing a Sex Surrogate."

Guedj had hoped to send a working group of associations for the disabled to Belgium and Switzerland to see how the process works in places where sexual assistance is legal.

In Belgium, however, people involved say the reality is more complicated than the law indicates, because the provision of sexual services is part of a murky legal netherworld initially created to counter the criminal aspects of prostitution.

"This kind of care has no legal framework," said Miek Scheepers, chairwoman of Aditi. "When it comes to legal protection, labor law and finances, we still have a lot to do."

The organization hopes to impose requirements like coursework on the needs of the disabled, medical certificates and a system of client feedback. But money is hard to come by.

"Every year we get more queries. There is need for a proper debate and especially a need for subsidies so that this operation can continue to exist," Scheepers said.

In the Netherlands, where prostitution is legal, disabled people are given a certain amount of money per month that can be used for sexual assistance if they choose. But for those who depend on the state funds, even a single visit would wipe out a solid chunk of their spending money. The visits are not considered part of basic health insurance, although some cities provide municipal funds.

France's Minister for the Handicapped, Marie-Arlette Carlotti, said Guedj's initiative is premature, but she welcomed a French debate on the issue.

"We're lagging a bit in France," Carlotti told Europe 1 radio in an interview last Friday. "Reflecting on the emotional and sexual life should be a legitimate question."

In 2011, a conservative French lawmaker released a report recommending sexual assistance for the disabled but it went nowhere.

"We want a public debate. We have to ask real questions, about ethics but also about fundamental rights for the handicapped," said Ribes, the French activist. In France, she said, "we consider people who are handicapped not people in and of themselves, but as objects of care."

Casert reported from Brussels. Toby Sterling in Amsterdam contributed to this story.

Copyright 2013 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

March 24, 2013 ( SPRINGFIELD, Ill.) AP -- The sponsor of a bill that would allow marijuana use for medical purposes in Illinois says the measure is just "one or two" votes short of passage in the House.

Rep. Lou Lang tells the Pekin Daily Times he's close to getting the support he needs for the four-year pilot program. The Skokie Democrat's measure would allow patients with specific medical conditions to obtain marijuana.

Patients would be limited to 2.5 ounces every two weeks. Supporters say marijuana can relieve pain without the side effects of some prescription drugs.

Opponents include Anita Bedell of Illinois Church Action on Alcohol and Addiction Problems. She says 2.5 ounces is "a huge amount" that would give patients an opportunity to sell what they don't use.

Thursday, March 28, 2013

What does disability discrimination look like? Believe it or not, it can look like a National Public Radio piece.

On March 22nd and 23rd NPR aired a series of programs titled "Unfit for Work: The startling rise of disability in America" on All Things Considered and This American Life. The story greatly misrepresents the Social Security disability programs, including SSDI and SSI, and contains significant errors. The story can be read and listened to at: http://apps.npr.org/unfit-for-work/.

Disability advocates nationwide are mobilizing in response to let NPR know that this kind of shoddy reportage is discriminatory and defamatory.

One of the major problems with the NPR coverage is that it portrays people as “using” their disability to scam the government. This plays right into the hands of people who believe that people with disabilities are “faking it” in order to use “entitlements” to rob tax payers of their hard earned dollars. The NPR story is being fanned into major news on outlets nationwide, with the result being that people who legitimately qualify as being too disabled to work are being scapegoated as the reason for our country’s fiscal crisis.

Seems like people figure that if you can’t blame the national budget crisis on race or class, you might as well blame it on people with disabilities. The NPR story fans the flames of this attitude and must be exposed for the piece of bias that it is.

Take action! You can email response letters directly to Gary E. Knell, President and CEO of NPR. The e-mail contact form is http://helpqa.npr.org/npr/includes/customer/npr/custforms/contactus.aspx. You can also call NPR via its Listener Services at (202) 513-3232. His Twitter handle is @NPRGaryKnell if you have Twitter and want to tweet at him on this issue.

At this point in time, Ira Glass and NPR are still standing by their story. Advocacy to ask them to air a follow up piece, including the voices of people on SSI and systems advocates, will continue.

After reviewing the information shared from Access Living, I am taken back and disappointed in National Public Radio (NPR). We did send a brief message to Gary E. Knell, President and CEO of NPR. Please take a little bit of your time and respond to NPR, and please share this info. TY, Jim

Mr. Knell,
On March 22nd and 23rd NPR aired a series of programs titled "Unfit for Work. I am taken back and disappointed in National Public Radio (NPR). One of many concerns on the reporting is that there was no deferential from Those of us that live with a Disability, and the possibility that some are misrepresenting there medical condition for personnel gain. There is an extreme lack of full or part-time job opportunities for people with disabilities.

This is the type of 'story' that usually associated with the extreme part of the Republican Party (and FOX News). I would expect more from NPR, an in-partial report on any story. NPR - SHAME ON YOU.
Jim Watkins, exec. director
Ability Chicago

Wednesday, March 27, 2013

As we mark the 10th anniversary of the start of the Iraq war, people want to know how VA is taking care of our Veterans. There has been a lot of discussion recently about the compensation claims backlog and what the Department of Veterans Affairs (VA) is doing about it.

We at VA – many of us Veterans ourselves – know that Veterans, their families and survivors wait too long for the benefits they have earned and deserve. The fact is our average days-to-complete a claim currently sits at 273 days. All of us at VA agree this is unacceptable, and this is why we have been busy implementing a robust plan to fix the problem and end our reliance on paper-based claims.

Secretary Shinseki has set the goal: no claim over 125 days with 98% accuracy by the end of 2015. VA is aggressively building a strong foundation for a paperless, digital disability claims system – a lasting solution that will transform how we operate and eliminate the backlog. This new system will be installed in all 56 of our regional offices by the end of this year. Twenty-five offices have it now.

The backlog didn’t happen overnight, and it won’t end overnight. After ten years at war, the volume and complexity of claims is increasing as more servicemembers leave the military. Improved battlefield medicine has meant that more of our younger Veterans are coming home to their families, but with very complex injuries.

Claims submitted by Post-9/11 Veterans include more than double the number of conditions claimed by Veterans of the Vietnam era. To put this in perspective, in 2009 (the year Secretary Shinseki assumed office), VA processed claims for 2.7 million individual medical conditions. Last year, that number had grown to over 4 million.

At the same time, Veterans of previous wars are living longer and many have the opportunity to file for benefits for the first time, thanks to decisions made by Secretary Shinseki. These decisions to do right by Veterans were long overdue, and have dramatically increased access for many Veterans who would not otherwise been able to file for benefits. The decision to expand the number of illnesses presumed to be linked with Agent Orange exposure redirected over one third of VBA’s workforce to process 260,000 Agent Orange claims. This grew the backlog, but it was the right decision to make for our Vietnam Veterans who, in some cases, were waiting over 40 years. In fact, Vietnam-era Veterans represent the largest group in the current claims inventory at 37%.

We also liberalized the rules for connecting PTSD to service, as well as adding nine diseases associated with service in the Gulf War to the list of presumptive conditions – again, long overdue. Over the last 4 years, over 940,000 Veterans were added to the compensation rolls — more Veterans than are on Active Duty in the Army and Navy combined today.

A tough economy and increased outreach efforts by VA to encourage Veterans to apply for earned benefits have also made our effort to tackle the backlog more challenging. Despite this, VA has completed a record-breaking 1 million claims per year the last three fiscal years, and completed 4.1 million claims the past four years. In 2012 alone, VA provided $58.6 billion in disability compensation to 4.3 million Veterans and survivors.
In this challenging environment, there are several new initiatives – as part of the VA Transformation Plan – that Veterans and Veteran service representatives can take advantage of today to help VA process their claim as quickly as possible:

Disability Benefits Questionnaires (DBQ) are designed to capture all the needed medical information relevant to a specific condition and give Veterans the option of having their private physician provide this information to VA, minimizing the need for a VA exam. More than 70 DBQs are available today for use by private medical physicians.

Fully Developed Claims (FDC) identify the claim-specific information and evidence needed to substantiate a claim at the time of application, and allow Veterans to certify that there is nothing further to give VA regarding the claim, preventing VA from undertaking a lengthy search for any missing information or evidence
Veterans and survivors who are able to do so, should submit as much evidence as they can at the time they submit their claims. Doing so allows VA to work claims much faster — meaning Veterans and survivors get accurate decisions sooner.

The backlog is a decades old problem. We have studied it carefully and engaged with Veterans Service Organizations and others to determine the right approach. Eliminating the backlog requires a radical overhaul of the way VA does business and that takes time. The good news is we are on the right path to succeed and deliver faster, more accurate results for Veterans.

Allison Hickey, a retired U.S. Air Force Brigadier General, is VA’s Under Secretary for Benefits.

Ventra is Coming...
Starting in 2013, the CTA and Pace are transitioning to Ventra™, a convenient new payment system that will let you use a single fare card for regional transit throughout the Chicago area. The new system will make commuting easy and seamless because it is a convenient new way to access and pay for train and bus rides on CTA and Pace beginning in Summer 2013.
The transition to Ventra™ requires customers who currently have an RTA Ride Free , Reduced Fare or Disabled Reduced Fare permit to receive a new permit later this year. Existing customers will have to do nothing as the new Ventra™ compatible permits will be sent to the address on file at no cost. If your address has changed recently, please contact the RTA Customer Service Center at 312-913-3110.
For more questions about the Ventra™ transition, please view our frequently asked questions.

Seniors and people with disabilities who are enrolled in the Illinois Department on Aging’s Benefit Access program are eligible to ride free on the Chicago Transit Authority (CTA), Metra and pace fixed-route services. To ride free, you must first qualify and be enrolled in the Illinois Circuit Breaker program. This program is administered by the Illinois Department on Aging. The income levels for eligibility range from $27,610 or less for an individual, $36,635 for a two-person household, and $45,657 for a household of three or more people. Learn more about the Illinois Circuit Breaker program at www.cbrx.il.gov or call 1-800-252-8966 [TTY: 1-888-206-1327]. Information is also available at senior citizen centers, the Mayor’s Office on Disabilities in the City of Chicago, and Independent Living Centers.
Download the RTA Circuit Ride Free program brochureEnglish PDF Version (.pdf) Spanish PDF Version (.pdf)

Senior Circuit Ride Free Program (Formerly Senior Ride Free Program)
Seniors, aged 65 or older: If you are an Illinois resident, and currently enrolled in the Illinois Department on Aging’s Circuit Breaker Program, you are eligible for free transit on fixed routes operated by the Chicago Transit Authority (CTA), Metra and Pace.
If you not are an Illinois resident, aged 65 or older, you may be eligible for the RTA's Reduced Fare program.

Seniors who are enrolled in the Circuit Breaker program must apply for the RTA-issued Circuit Ride Free permit that will allow them to ride free on fixed-route transit in the RTA service region.
All seniors may apply in person at the RTA’s Customer Service Center at 165 N. Jefferson in Chicago. Our hours are Monday through Friday, 8:00 a.m. and 4:30 p.m. Call us at (312) 913-3110 for more information. You may also download an application here, or apply at any one of our 200 registration sites in the region. To find a site near you, call 836-7000 from any local area code or refer to the Circuit Ride Free Registration Site.
Circuit Ride Free Registration Sites - PDF Version (.pdf)

At the registration center, you will be required to present:
1. A valid government-issued picture identification card that verifies your age (drivers license, state ID card, alien registration card or passport).
2. A wallet-sized color photo of yourself that is approximately 1 1/2" square. Do not wear a hat, scarf or sunglasses in the photo. Some registration centers may charge up to $5 for taking your photo. The RTA’s Customer Service Center does not charge for this service. You should receive your new Circuit Ride Free permit in 3-4 weeks.

People with Disabilities Circuit Ride Free Program
If you are an Illinois resident, and currently enrolled in the Illinois Department on Aging’s Circuit Breaker Program as a person with a disability, you are eligible for free transit on fixed routes operated by the Chicago Transit Authority (CTA), Metra and Pace.
If you not are an Illinois resident, but a person with a disability, you may be eligible for the RTA's Reduced Fare program.

Individuals with a disability who are enrolled in the Circuit Breaker program must apply for the RTA-issued Circuit Ride Free permit that will allow them to ride free on fixed-route transit in the RTA service region.
People with disabilities may apply in person at the RTA’s Customer Service Center at 165 N. Jefferson in Chicago. Our hours are Monday through Friday, 8:00 a.m. and 4:30 p.m. Call us at (312) 913-5414 for more information. You may also apply at any one of our select registration sites in the region. To find a site near you, call 836-7000 from any local area code or refer to the People with Disabilities Ride Free Registration Sites.
People with Disabilities Ride Free Registration Sites - PDF Version (.pdf)

At the registration center, you will be required to present
3. A valid government-issued picture identification card that verifies your age (drivers license, state ID card, alien registration card or passport).
4. A wallet-sized color photo of yourself that is approximately 1 1/2" square. Do not wear a hat, scarf or sunglasses in the photo. Some registration centers may charge up to $5 for taking your photo. The RTA’s Customer Service Center does not charge for this service. You should receive your new Circuit Ride Free permit in 3-4 weeks.

Renewing Circuit Ride Free Permits
All circuit ride free permits will expire annually. Approximately two months before your expiration date, you will receive a renewal notice in the mail. Your permit cannot be renewed if you have not re-enrolled in the Illinois Department on Aging’s Circuit Breaker program. For information on renewing your Circuit Breaker enrollment, visit www.cbrx.il.gov or call 1-800-252-8966. Once your enrollment has been approved, you may call one of our customer service representatives at the RTA's Customer Service Center at 165 N. Jefferson in Chicago for more information on how to renew your permit. Our hours are Monday through Friday, 8:30 a.m. to 4:30 p.m. Please have your ID number at the bottom of your expired permit ready to give to the customer service representative. You may also reapply at any one of our registration sites in the region. To find a site near you, call 836-7000 from any local area code or RTA Circuit Ride Free Registration Site.

Replacement Permits
If your circuit ride free permit is lost or stolen, you must fill out a replacement application. The fee is $5.00 for the first replacement and $10.00 for each additional replacement. It is not necessary to submit another photo. You can download a replacement application here, or call 836-7000 to have one mailed to you.

As a sidenote to keep in mind, as the Ventra™ card transition goes forward, please check with the RTA, CTA, or PACE for updated information, questions, and concerns.
For Metra Train as details are available.

The Obama Administration has stopped paying the bills from hundreds of health care companies, and it has nothing to do with sequestration.

This is a story of bureaucratic mismanagement at the Centers for Medicare and Medicaid Services, and the harm it’s visiting on the diagnostic testing industry.

At issue is the way that Medicare reimburses everyone from the big laboratory companies such as the Laboratory Corp of America and Quest Diagnostics Inc., to the molecular diagnostic labs inside academic hospitals, and especially smaller firms that make proprietary tests used by doctors to more effectively target treatments to patients with conditions like cancer.

Some of these proprietary tests — focused around the more accurate diagnosis of prostate cancer — are profiled in today’s edition of the New York Times. The incompetent manner in which Medicare has handled a change in the reimbursement of similar tests has the potential to stymie one of the most important and potentially cost-saving technologies in the pipeline.

The molecular diagnostics in question are used to screen for everything from genetic markers that predict disease to proteins that help diagnose illnesses and guide peoples’ response to treatments. These tests are transforming the treatment of cancer, among many other maladies.

The Medicare agency decided to change the way it reimburses these sorts of diagnostic tests. But it’s been slow to decide on its new approach. So in the absence of a policy, the Medicare program is simply not paying its bills.

Previously, these diagnostics were reimbursed through a method called “code stacking.” Under this old approach, adding up the “cost” of each discrete step needed to perform a particular test derived the price paid for molecular tests.

This “cost plus” approach to setting payment rates was familiar to government actuaries. But it had many problems. Not least of which, it didn’t necessarily correlate payment rates with value – but merely the complexity of the test.

Some labs grew more adept than others at exploiting the payment scheme. A handful of crafty labs would create more complex tests, or “stack” additional steps in their molecular panels in order to game higher reimbursement.

The result was a lot of variability in what was paid for similar diagnostics, depending on which lab ran the test, and how good it was at “stacking” codes.

Moreover, private insurers that reflexively piggy backed on the Medicare payment scheme complained that the bills they got only identified a series of molecular testing steps. These bills didn’t pinpoint the actual test that was being performed. So insurers often didn’t know what they were paying for.

The private health plans could have fixed this on their own, by demanding that labs provide more information. But many health plans, looked to Medicare to fix the billing system. Under pressure, the agency said it would develop a new scheme.

The prior payment system was far from optimal. But so is Medicare’s approach to replacing it. Moreover, under the new payment schemes, even when Medicare starts to pay its bills again, the rates for individual tests are likely to come down. That was the overriding impetus for changing the scheme in the first place – to save the government money. It’s another reason why big lab companies that make a lot of their margin on the complex, molecular tests could get pinched going forward.

To move away from the “code stacking” and to a system that paid diagnostics based on what each product was testing for, in 2010 Medicare asked the American Medical Association to come up with specific codes for the most common (and important) molecular tests. There were 116 of these new codes in the first tranche. These test-specific codes became effective in 2011. But Medicare chose to retain the existing “stacking codes” and not convert to the molecular codes until 2012.

Why wait? The idea was to give Medicare time to set prices for each of these new codes. Medicare was urged by the labs to cross walk some average price being paid to existing tests to the new codes (perhaps a median or weighted average of the stacks being used, which CMS would be able to measure).

But Medicare didn’t trust the current prices. It didn’t want to import any relic of the flawed stacking system into the new codes.

But instead of coming up with a new system, CMS took the full year to do largely nothing. The agency sat on its hands. Then, only after winding down the clock, the agency announced that it would let the local Medicare carriers figure out what prices to assign to each of the different diagnostic codes (through a byzantine process called “gap filling”). In other words, Medicare punted.

It basically means that the local carriers, which contract with CMS to administer the Medicare program for different regions of the country, now have wide discretion to come up with their own prices. The entire punt gave the local Medicare contractors no time – and no clear direction – on how to assign prices to the different diagnostic codes. The result is that no prices have been established for the vast majority of the marketplace. And so many tests simply aren’t being paid for.

This is having a profound impact on the market for developing new tests. Investors are shunning new investments as this gets sorted out. It says nothing about how these rates are ultimately going to be established, and whether the prices that the government assigns will reflect the value and innovation that these products offer.

There has also been little transparency around how the local Medicare carriers are coming up with their price schedules. There’s no right of appeal from affected companies. And no clear methodology on how this all gets done.

The political class talks about the need to more effectively target treatments to help improve medical outcomes and drive more value. Yet they are systematically unraveling the very technology that is going to enable this sort of personalization.

In practice, what’s happening is that contractors are starting to copy the price schedule of the only Medicare contractor setting some sort of rates – the contractor that covers California (the firm Palmetto). In effect, the State of California may end up setting prices paid for most of the molecular diagnostics marketplace.

Some contractors have not priced anything, such as the Medicare contractor for the market covering Florida. That means diagnostic labs located in markets like Florida aren’t getting paid at all. In many cases, Medicare contractors look into setting a price only after they see a lot of claims for the same sort of test.

There’s no clear deadline on when this will all get resolved. There’s some speculation that when the Medicare contractors submit their 2013 pricing on April 30th, they’ll have to declare their prices for these various molecular tests. Once they do, the labs should get paid retroactively. But the April 30th deadline seems soft. This could linger much longer.

There’s also a risk for labs that the individual Medicare contractors may decide not to pay for certain codes (and tests) altogether.

This sort of bungling may be without precedent, even for the Medicare agency, which is quietly viewed in Washington – among both Democrats and Republicans – as being poorly administered. This isn’t a political slur. The agency’s skill level seems to persist equitably through transitions in political power. Problems emanating from CMS have cursed both Republicans and Democrats alike.

Diagnostic tests were supposed to usher in an age of personalized medicine. Now they’re being actively priced controlled. And by a bureaucratic regime that can’t even figure out what prices they want to pay for these services.

Follow Dr. Scott Gottlieb on Twitter @ScottGottliebMD. Dr. Scott Gottlieb is a director to two clinical lab companies that have not been affected by the current problems.

For the blind, sight-based technology can sometimes be a stumbling block. Most computers, phones and gadgets are built around a visual interface.

These visual interfaces are becoming more and more integrated into everyday life, which can make things harder for blind people and folks with severely diminished eyesight.

But these selfsame technologies can also be huge assets to blind people as well. Computers have millions of potential uses for complementing and enhancing day-to-day life. You just need the right software.

Screen reading technology has been around for decades now, but many screen readers can be prohibitively expensive, or else they aren't designed to meet a blind person's specific needs.

NVDA, which stands for NonVisual Desktop Access, is a free, open-source screen reader that converts text and visual cues on your computer into a synthetic voice. It was created by two blind software programmers to help them use their own computers.

To download NVDA, click on the link labeled "NVDA 2012.3.1 main package." It's located underneath the header "Stable Release."

You'll then be asked to make a donation, which isn't necessary to use the full product. Simply click the corresponding link near the bottom of the page, though you may decide you wish to voluntarily support this free product at any time.

As you're installing NVDA, it will begin reading the text and visual cues where your mouse is hovering. You can even choose to install it as a portable version to a USB flash drive. That's a good choice if you want to use NVDA on any computer you plug the drive into.

Once you've installed NVDA, you can control settings, inflection, voice, hotkeys and much more by opening up the NVDA menu. The default way of doing this is by pressing "Insert + N" although before you launch for the first time, you'll be asked if you'd rather use Caps Lock than Insert.

If you are using Internet Explorer and your download does not begin within 30 seconds after activating a download link, the download has probably been blocked. If this happens, the Information Bar will appear and you may hear an accompanying sound, but this may not be announced by screen readers. Please do the following to begin the download:

1)Press alt+n to move to the Information Bar, which will inform you that the download has been blocked.
2)Press space to activate the button to show options. A menu will appear.
3)Select and activate the Download item. You can do this quickly by pressing d.
4)The normal download options will now appear. Begin the download as normal.

Stable Release: 2012.3.1 (recommended for most users)

This release is suitable for production use.

NVDA 2012.3.1 main package
What's new in 2012.3.1

Beta Release: 2013.1beta1 (recommended for testers only)

This release is intended for those who are interested in testing and evaluating the upcoming stable release, but is not recommended for production use. Testers are encouraged to report any bugs found while using this beta.

NVDA 2013.1beta1 main package
What's new in 2013.1beta1

Old Releases

Old releases can be downloaded from ​SourceForge.

Development Code

Please see the Development section for information about accessing development code, including both source code and binary snapshots.

Keep Up To Date

Keep up to date with the latest NVDA news including announcement of new releases and subscribe to NVDA.

Tuesday, March 26, 2013

Effective July 1, 2012, Illinois Cares Rx was terminated and the Circuit Breaker Property Tax Relief Grant was eliminated due to the lack of funding.(this post links updated & verified on January 3rd, 2017)

The benefits now available are:

Seniors Free Transit Ride

The Persons with Disabilities Free Transit Ride

Secretary of State License Plate Discount

To be determined eligible for these benefits, you must submit aBenefit Access Application on the Internet. Paper applications are not available.Please note that current processing times to determine eligibility of your Benefits Access Application is 4-6 weeks.

Once your application is approved you may print a certificate of eligibility to take to your local transit authority or Secretary of State Office. Please wait 10 business days from the date of your approval for your license plate discount to be available. If you requested the ride free benefit, please contact your local public transit system for further information. Your local transit system may have additional requirements in order to obtain the free ride. You can check the website at anytime to determine your application status.

If you have questions or would like to locate a Senior Health Assistance Program (SHAP) site near you for assistance, contact the Senior HelpLine at 1-800-252-8966, 1-888-206-1327 (TTY).

CHICAGO — Longwood Manor resident Beverly Johnson has lived with multiple sclerosis for over 20 years. When she was diagnosed in the summer of 1993 there weren’t many treatments for MS, and she was stricken with the fear of an uncertain future. In 2002, at a family reunion in Mississippi, she got very sick. She became over-heated, lost her vision and she had trouble walking. Once she returned home to Chicago, Johnson decided she would do whatever she could to take care of herself. It was the following year that she participated in her first Walk MS, the largest annual fundraiser of the Greater Illinois Chapter of the National Multiple Sclerosis Society, and she’s partaken every year since.

“I embraced Walk MS because I saw the difference that even small gestures made,” said Johnson, who is captain of her Walk MS team, Bev’s Crew. “I felt the importance of not only raising money but also talking to others about the disease.”

On Sunday, May 5, Johnson and Bev’s Crew will join thousands of other participants at Chicago’s Lakefront Walk site, located in Grant Park (Columbus and Balbo Dr.). The Chicago Lakefront is the largest of the Greater Illinois Chapter’s 11 Walk MS sites, attracting up to 5,000 participants every year.

Walk MS 2013 will mark Johnson’s 11th year participating. She has repeatedly been one of the event’s top fundraisers, having raised nearly $16,000 in 2012.

“When I hear about all the medical breakthroughs—what the latest research has been able to help discover—and new medications being developed to help people living with MS, it encourages me to fundraise,” said Johnson. “It lets me know that all the money I raise at Walk MS is getting good use.”

Johnson hopes that someday soon that the dollars raised and the ongoing research will help to eradicate the disease. To her, a world without MS means living in peace knowing that her friends and family don’t have to worry about the effects that MS has on the body.

“I used to walk for the advancement of new medications that help people with MS live more comfortably; I’m proud of how far we’ve come,” said Johnson. “Now, I walk for a cure.”

To participate in Walk MS 2013 as an individual, volunteer, or part of a team, visit walkMSillinois.org or call 1.800. 344.4867.

The National MS Society addresses the challenges of each person affected by MS. To fulfill this mission, the Society funds cutting-edge research, drives change through advocacy, facilitates professional education, collaborates with MS organizations around the world, and provides programs and services designed to help people with MS and their families move forward with their lives.

The disease affects more than 20,000 people in Illinois and 2.1 million worldwide.

WASHINGTON -- Whether it means opening school track meets to a deaf child or developing a new lunch menu with safe alternatives for students with food allergies, recent Obama administration decisions could significantly affect Americans with disabilities. But there's been little progress in one of the most stubborn challenges: employing the disabled.

According to government labour data, of the 29 million working-age Americans with a disability -- those who are 16 years and older -- 5.2 million are employed. That's 18 per cent of the disabled population and is down from 20 per cent four years ago. The employment rate for people without a disability was 63 per cent in February.

The job numbers for the disabled haven't budged much since the passage of the Americans with Disabilities Act of 1990, which gave millions of disabled people civil rights protections and guaranteed equal opportunity in employment, public accommodations, transportation, government services and more.

The National Council on Disability's Jeff Rosen said long-standing prejudicial attitudes need to be addressed to boost jobs.

"Employers are still catching on to the fact that the needs of most workers with disabilities aren't special, but employees with disabilities often bring specialized skills to the workplace,"

Rosen said. "Perhaps no one knows how to adapt, think critically or find solutions better than someone who has to do so daily in order to navigate a world that wasn't built with them in mind."

Rosen, who is deaf, was named in January as chairman of the council, an independent federal agency that advises the president, Congress and other federal agencies on disability policy.

The Obama administration recently has acted to expand the rights of Americans with disabilities in other areas.

The Education Department's civil rights division released new guidelines that direct schools to provide students with disabilities equal access to extracurricular sports teams. If schools can't, they should create similar athletic programs for disabled children, the department said.

Also, the Justice Department said in a settlement with a Massachusetts college, Lesley University, that severe food allergies can be considered a disability under the law. That potentially could lead to new menus and accommodations at schools, restaurants and other places to address the needs of people with food allergies.

One silver lining in the lagging employment for the disabled has been federal hiring.

The latest data from the U.S. Office of Personnel Management shows nearly 15 per cent of new federal hires between 2010 and 2011 were people with disabilities -- almost 19,000 people. That's up from the previous year when about 10 per cent of new hires were people with disabilities.

President Barack Obama signed an executive order in 2010 aimed at improving the federal ranks of people with disabilities. The goal was to add 100,000 disabled people to federal payrolls in five years; that would be within reach if the 2010-2011 hiring numbers were to stick or improve.

Federal agencies are trying to achieve the numbers through better recruitment, especially at colleges and universities. And last month, OPM issued rules to limit the paperwork that potential hires with disabilities would need to provide. They essentially "self identify" as disabled by qualifying for a special hiring category known as "Schedule A" that allows disabled people to apply for a job through a noncompetitive hiring process, meaning they could be hired without competing with the general public.

The administration also is considering new rules that would leverage the power of federal spending to encourage companies to hire more disabled workers. The Labor Department is weighing a rule that would require companies with federal contracts to set a goal of having at least 7 per cent of their workforce be disabled. Federal contractors employ nearly one-quarter of the nation's workforce.

Since the rule was proposed more than a year ago, business groups have complained that it would be too burdensome and lead to conflicts with federal laws that discourage companies from asking job applicants to identify themselves as disabled.

"We have had a long history of supporting the disabled community," said Randel Johnson, vice-president at the U.S. Chamber of Commerce for labour issues. "But this proposal goes too far, woefully underestimates cost of compliance, and is completely unworkable as structured in the proposal."

Jennifer Lortie, 29, of Griswold, Conn., considers herself one of the lucky employed Americans with a disability.

Lortie was born with cerebral palsy and has limited use of her arms and legs. She graduated college during the recession and it was no easy task finding a job.

She spent more than a year scouring newspapers, job search websites and sending out dozens of resumes. She worried her wheelchair might be a strike against her until she landed a position in 2009 as an assistive technology specialist with the Connecticut Tech Act Project. The federally-funded program aims to increase independence for people with disabilities by educating them on new and best-fit technologies for work, school and community living.

"I think helping people kind of makes me think maybe there's a reason that I am in a wheelchair," Lortie said in an interview. "There has to be some reason to all this, so it gives me a sense of purpose as far as 'OK, I'm in a wheelchair but I can help other people' instead of just sitting home feeling sorry for myself."

Lortie spends four hours each day commuting to work and then back to the home she shares with her parents. They drive her to the bus stop and then she takes two buses to get to work -- two hours each morning and two hours at the end of the day to get home. And she doesn't mind a bit. "I like to help people," she said.

Jill Houghton works with companies to expand employment for people with disabilities. Among the big barriers, she said, are concerns about cost. Companies worry about whether they'll have to make special accommodations or additional training and they want to know how much it's going to cost.

"The reality is that businesses have found that when they create inclusive workplaces, where people with disabilities are working side by side with people without disabilities ... the bottom line is that it doesn't increase costs," said Houghton, who heads the US Business Leadership Network, a trade association that represents about 5,000 businesses.

She said she has noticed a significant increase in calls and requests recently to the group from the business community about hiring people with disabilities.

Companies want to be inclusive of people with disabilities, Houghton said. "Businesses are learning that it just makes good business sense."

This week and next week are critical opportunities for disability advocates to let our state legislators know which state-funded programs are important to us. The Governor has made his budget proposal, and it is the job of our legislators to arrive at the budget they will approve by the end of May. The Governor defended many programs that empowered people with disabilities to live in the community by either not making cuts or making some increases. He has also made it clear that he values peer support programs and the self-determination of people with disabilities to live the lives we want. This is good news, so far.

The tricky part is, the Governor’s estimate for his proposed budget is $600 million more than the General Assembly estimates it can spend. So the question is, will our state legislators decide to cut away at the budgets of programs that people with disabilities need? If so, we face a tremendous risk that many people with disabilities may face institutionalization, which costs more than community services.

Access Living supports funding for a wide range of disability programs that affect people with all types of disabilities. Our main priority is to fight for funding that will allow people to live in their own homes and communities. Plus, programs that offer peer support by and for people with disabilities are irrepleaceable. Thus, we urge you to tell your legislators to support the Governor’s funding proposals for:

The Home Services Program (HSP)
The Community Care Program (CCP)
Centers for Independent Living
The Community Reintegration Program

Both HSP and CCP are in need of supplemental funding for the current year’s budget in order to avoid back bills. We also urge legislators to increase funding for mental health programs and permanent supportive housing to address our state’s community mental health services crisis.

In addition, we urge legislators to carefully consider what should be in the legislative package to make “adjustments” to the SMART Act, which was passed last year to try to deal with the funding crisis in Illinois Medicaid. Among many issues, we support the position that prescriptions for people with mental illness and chronic disabilities should be exempted from the four prescription Medicaid drug limit. We also support the inclusion of the language in SB 1733/HB 2502, which affects access to complex rehab technology and improves the process for Medicaid funded wheelchair repairs., a burning issue for thousands of wheelchair users.

Contact your legislators today by using our “Take Action” link (if you are reading this by email) or by using the form below (if you are reading this on our website). FREE OUR PEOPLE!

In my work helping to develop policies on accessible workplace technology, I have sometimes fallen into the trap of looking just at the “little picture.” By that I mean that sometimes I’ve focused too much attention on making sure that information and communications technology is (ICT) is compatible, or interoperable, with assistive technology specifically screen readers. I know I’m not the only one who has made this mistake, because I come across a lot of information suggesting that once a website is found to work with a screen reader or another type of assistive technology, the accessibility discussion can simply end there. Millions of people around the world use assistive technology, so it is understandable that interoperability is a very important issue. But it sometimes commands so much attention that we forget to look at the “big picture” of fully accessible ICT or the biggest picture of all, universal design.

I find it odd that I have made this mistake since I do not use a screen reader and thanks to laser eye surgery, now have very good eyesight. But I know that may not last forever. Still, what is more likely than the possibility that I might have to rely on a screen reader at some point in the future is the fact that my neuromuscular disease will continue to progress to the point where severe muscle weakness limits my ability to use a computer keyboard or mouse.

Typing long documents has already become difficult enough that I have begun to use speech-to-text technology. In fact, I am composing this blog post using Dragon Naturally Speaking, a speech-recognition software product. I’ll have to thank the person who introduced me to the software and showed me how to train it to recognize my voice. Before I met her, I thought “How to Train Your Dragon” was only a children’s movie, albeit an entertaining one. But if I want to correct one of the many mistakes I am making (correction: that the software is making) right now as I work on this document, I can still do that using the keyboard. Eventually, though, this will change and I will need to turn to technology to find a solution.

So when I get a question about why accessible ICT is so important to me considering the fact that I “only” use a wheelchair (yes, it has happened), I take the opportunity to explain what the future holds for me and why the issue will very likely hit close to home. I also explain that we, those who have a disability and those who do not yet have a disability, are all in the same boat. As more and more people age, they will likely begin to be affected by impairments or disabilities, and this fact alone will account for millions of people who will rely on assistive technology and accessible ICT in their daily lives.

Aside from interoperability with assistive technology, what else does accessible ICT entail? I certainly will not attempt to provide an exhaustive answer to that question here. But if we restrict ourselves to the topic of accessible web content, which I acknowledge is not really much of a restriction considering the amount of information on the internet, we find things like the World Wide Web Consortium’s (W3C) Web Content Accessibility Guidelines (WCAG) 2.0. WCAG 2.0 aims to provide a shared standard for accessible web content that relies on that content being: perceivable, operable, understandable and robust.

I encourage you to read WCAG 2.0 for a fuller understanding of the issues behind these guiding principles, but some examples include making sure that web pages: provide sign language interpretation for all prerecorded audio content; avoid using content that flashes too quickly and could trigger a seizure due to some individuals’ photosensitivity; and clearly explain figurative language or specialized words that would be difficult for some people to understand.

Keeping true to these four guiding principles is essential considering the ever-changing landscape of emerging technologies such as cloud computing, mobile devices and social media – and their increasing use with regard to employment. When these technologies are used in the context of the employment of individuals with disabilities, specifically as tools to help people find jobs or do their jobs, they become employment supports. One of the three priority areas for my office, the U.S. Department of Labor’s Office of Disability Employment Policy, is the expansion of access to employment supports and accommodations. Our aim is to ensure that existing and emerging technologies take into account the needs and perspectives of jobseekers and employees with disabilities, and that our policymaking is focused properly.

Through a recently launched initiative with the U.S. General Services Administration (GSA), we are currently collecting best practices that agencies, companies and others can use to help ensure that their social content is accessible to persons with disabilities and all who need it. These efforts are responsive to three very notable trends:

The increase in the number of employers, organizations and federal agencies who use social media to interact with their communities and stakeholders (including for recruitment);
The increase in the number of jobseekers with and without disabilities who are using social media to look for and apply to jobs, discuss job openings and job-search tips, create résumés and establish networks of professional connections; and
The increased need to use images and videos to promote online interaction with stakeholders and other targeted audiences, which without accessibility considerations make participation difficult for persons with disabilities and others.
The work that we and many others are doing in this area is important because, unfortunately, the supply of accessible social media has not kept up with the demand for it. A 2012 survey of more than 1,600 screen reader users found that 33.7 percent found social media to be either “inaccessible” or “very inaccessible.” I encourage you to be part of these efforts and to share your knowledge and expertise by adding tips and comments to the evolving “Improving the Accessibility of Social Media in Government” toolkit.

As I noted above, screen reader interoperability is not the be all and end all of accessible ICT. It is certainly an important metric, but we should also look to the extent to which agencies, organizations and companies comply with WCAG 2.0, as well as the accessibility standards for electronic and information technology pursuant to Section 508 of the Rehabilitation Act of 1973, as amended, or the accessibility guidelines for telecommunications devices pursuant to Section 255 of the Communications Act of 1934, as amended. But no matter which standard(s) for accessibility we use, we must bear in mind that making progress with accessibility or compliance today does not mean we can become lax or stop striving for more universal access in the future – particularly as technology continues to evolve in the years to come.

Mario Damiani is a Policy Advisor at the U.S. Department of Labor’s Office of Disability Employment Policy (ODEP). During his tenure, which began in 2006, he has worked primarily on issues related to accessible workplace technology, as well as on issues such as workplace personal assistant services, reasonable accommodations and increasing the employment of individuals with disabilities in the federal government and federal contractor sector. In addition, Mr. Damiani serves as co-lead for ODEP’s online collaborative policymaking workspace, ePolicyWorks. He also serves as a Staff Liaison to the United States Access Board for Board Member and ODEP Assistant Secretary Kathleen Martinez.

Prior to joining ODEP, Mario worked as an attorney for the District of Columbia Department of Health and a law clerk at both the District of Columbia Court of Appeals and Office of Bar Counsel. He received his Bachelor of Arts and Juris Doctor degrees from The Catholic University of America in Washington, D.C. He and his wife Theresa reside in suburban Maryland.

As Posted at DisabilityGov.Blog
http://usodep.blogs.govdelivery.com/2013/03/25/accessible-information-communications-technology-and-social-media-why-they-matter/

Supervalu Inc. may be a much different company after Thursday’s $3.3 billion sale of its largest grocery properties, but it continues to be haunted by discrimination issues in its past.

On Thursday, Supervalu was found by a U.S. District Court in Chicago to have violated a 2011 federal disability lawsuit settlement involving the Eden Prairie firm’s Jewel-Osco grocery store chain in Chicago, a business that was part of Thursday’s sale to Cerberus Capital Management.

The court action requires Supervalu to make job offers to Jewel-Osco workers who, as of Friday, are no longer Supervalu employees.

“Because this is pending litigation, we’re not in a position right now to comment on whose responsibility it is,” said Miguel Alba, a spokesman for Jewel-Osco, which operates 176 grocery stores in Illinois, Indiana and Iowa.

However, the legal issue is not a new one, said attorney Marshall Tanick of Twin Cities law firm Hellmuth & Johnson. To some degree, whether Supervalu or the Cerberus is responsible for obeying the 2011 lawsuit settlement will depend on what was negotiated in the sales agreement, said Tanick, an employment law attorney who is not connected to the case. But regardless of what was negotiated, the courts lean toward requiring the buyer to carry out the responsibilities of a settlement, provided the buyer operates the business in the same way the seller did, Tanick said.

The 2011 settlement was intended to end a 2009 lawsuit filed by the federal Equal Employment Opportunity Commission that accused Supervalu of dumping 110 disabled Chicago-area employees of Jewel-Osco at the end of their medical leaves. At the time, the $3.2 million settlement was one of the largest ever recorded under the federal Americans With Disabilities Act, which says that employees with disabilities should, at the end of the medical leaves, be brought back to work with reasonable accommodations.

On Thursday, U.S. District Judge Ronald Guzman held Supervalu in contempt for violating the settlement terms by failing to send written job offers to three employees on disability leave who were able to return to work. The judge ordered Supervalu to send written return-to-work offers to all disabled workers who were capable of returning to work between January 2011 and April 2012.

Also on Thursday, Supervalu made its anticipated announcement that it had closed the $3.3 billion sale of its four largest grocery store chains to an affiliate of Cerberus and other investors, driving up the price of its stock up 11.7 percent.

According to the EEOC, Jewel-Osco had a policy and practice of terminating employees with disabilities at the end of medical leaves of absence rather than bringing them back to work with reasonable accommodations. Approximately 1,000 employees of the defendants’ Jewel-Osco stores in the greater Chicago area were allegedly terminated under this policy since 2003, the EEOC said. Not all of these former employees wished to participate in the suit or were found eligible by the EEOC.

Such alleged conduct violates the Americans With Disabilities Act (ADA). The EEOC filed suit in U.S. District Court for the Northern District of Illinois (Case No. 09-cv-5637) after first attempting to reach a pre-litigation settlement through its conciliation process.

The consent decree resolving the case, signed this morning by Federal District Chief Judge Ronald Guzman, provides for a fund in which 110 individuals will share, bringing the average award to approximately $29,000 per claimant. In addition to the monetary relief, Jewel-Osco is required to ensure that its employees involved in making accommodation decisions undergo training on the requirements of the ADA and on the types of accommodations that are available to return their employees to the workplace.

Jewel-Osco will also hire consultants to review and recommend changes to its current job descriptions, ensure that the descriptions of the physical requirements of the job are accurate and provide recommendations on possible accommodations to common work restrictions in various positions in the stores. The company will have to report regularly to the EEOC on its efforts to accommodate employees with disabilities who are attempting to return from medical leaves of absence. Furthermore, Jewel-Osco will revise its communications with such employees to assure them that they need not be 100% healed in order to be considered for a return to work, and to inform them of some of the types of accommodations that may be available to them if they are considering returning to work with medical restrictions.

“This very important settlement underscores the EEOC’s commitment to vigorous enforcement of the Americans With Disabilities Act and to ensuring that all workers receive fair and equal treatment in the workplace,” said EEOC Chair Jacqueline A. Berrien.

Regional Attorney John Hendrickson of the EEOC’s Chicago District Office said, “It is vital that employers understand that the primary goal of the ADA is to allow people with disabilities to be active and productive members of the work force,” “Sending them home, with reduced or no pay, and without the ability to advance, thwarts that purpose. I am concerned that some employers believe that keeping an employee who is able to work off the job and on a leave of absence is a reasonable accommodation relieving them of further obligations under the ADA. Such a belief could lead to costly mistakes.”

EEOC Supervisory Trial Attorney Gregory Gochanour added, “We are very pleased with the resolution of this case. Not only have we obtained significant financial relief for a large number of former Jewel and Osco employees, the employment practices that these stores use will be greatly improved. This is a win for the employees and a win for the company as well--it will retain employees who would have been discharged in the past, and so will continue to receive their productive and valuable services.”

In addition to Hendrickson and Gochanour, the EEOC was represented by Chicago Trial Attorneys Ethan Cohen, Gordon Waldron, Aaron DeCamp, Laurie Elkin, Deborah Hamilton, Richard Mrizek and Grayson Walker. EEOC attorneys from Milwaukee, Minneapolis, Detroit, Indianapolis and St. Louis also participated in the litigation. According to Hendrickson, the EEOC’s utilization of attorneys from numerous offices was consistent with the agency’s adoption of a “national law firm model” approach to important cases challenging systemic discrimination, and “it demonstrates once again that EEOC has the capability to successfully litigate large cases against major employers.”

The EEOC Chicago District Office is responsible for processing charges of discrimination, administrative enforcement, and the conduct of agency litigation in Illinois, Wisconsin, Minnesota, Iowa, and North and South Dakota, with Area Offices in Milwaukee and Minneapolis.

The EEOC enforces federal laws prohibiting employment discrimination. Further information about the agency is available on its web site at www.eeoc.gov.

Friday, March 22, 2013

Advocates for Blind, Deaf Say Netflix, Target Are Legally Obligated to Make Sites Easier to Navigate

article by JOE PALAZZOLO; The Wall Street Journal, March 22, 2013

Commerce has moved online. Now, the disability lawsuits are following.

Advocates for disabled Americans have declared that companies have a legal obligation to make their websites as accessible as their stores, and they've filed suits across the country to force them to install the digital version of wheelchair ramps and self-opening doors.

Their theory that the 1990 Americans with Disabilities Act applies to the modern Internet has been dismissed by several courts. Still, the National Federation of the Blind and the National Association of the Deaf have won legal victories against companies such as Target Corp. and Netflix Inc. Both companies settled the cases after federal judges rejected arguments that their websites were beyond the scope of the ADA.
[photo: Anne Taylor uses a Google Nexus 7 tablet at the National Federation of the Blind in Baltimore.Stephen Voss for The Wall Street Journal]

"It's what I call 'eat your spinach' litigation," said Daniel F. Goldstein, a Baltimore lawyer who represents the NFB. "The market share you gain is more than the costs of making your site accessible."

Several other companies have worked with the NFB to make their websites more accessible to people with disabilities, including eBay Inc., Monster.com, Travelocity and Ticketmaster.

Eric Goldman, a professor at Santa Clara University School of Law, said most courts have ruled that online spaces aren't covered by the ADA. "Congress never contemplated the Internet at the time, and if they had, they would have included it," he said.

But that could soon change. The U.S. Department of Justice is expected to issue new regulations on website accessibility later this year that could take a broad view of the ADA's jurisdiction over websites. A Justice Department spokeswoman declined to comment.

That could mean websites will be required to include spoken descriptions of photos and text boxes for the blind, as well as captions and transcriptions of multimedia features for the deaf, said Jared Smith, associate director of WebAIM, a nonprofit group that trains and evaluates companies on Web accessibility.

Mr. Smith also advises companies to ensure that people with motor disabilities can navigate websites without the use of a mouse, and to use plain language and a strong design to aid people with cognitive or intellectual disabilities.

Lawyers who represent companies in ADA cases say an expansive reading of the law could expose their clients to a rash of frivolous lawsuits. They also argue that companies face a considerable burden in ensuring their websites are compatible with the latest technologies for aiding the disabled, such as software that reads aloud text on the screen.

"It's in everybody's interest to make sure that disabled people have access to websites, but whether the law is the avenue to achieve that change is another question," said Matthew Kreeger, who represented Target. "It's kind of a blunt instrument."

Not for Anne Taylor, who has to guess where to type in her name, credit card information and address when she shops online on websites that aren't accessible to the blind. She gets some help from the computer voice that alerts her when she runs her mouse cursor across a "text box."

Ms. Taylor, the director of access technologies at the NFB, which represents an estimated 25 million adults with vision loss, said she can usually figure out which bit of her personal information goes into which box, given her area of expertise.

"But this isn't the experience we want blind people to have," she said. "This is not an experience a company would want a sighted person to have."

Research has exposed vast gaps in accessibility. Jonathan Lazar, a professor at Towson University, studied 16 employment websites in 2012 and found that applicants who were blind required assistance more than two-thirds of the time.

The costs of making a website accessible vary based on the complexity of a website, and it is much cheaper to build accessibility features into a new site than to retrofit an old one, experts said.

Tim Springer, chief executive of SSB BART Group, which advises companies on accessibility, said companies can expect to pay about 10% of their total website costs on retrofitting. But if they phase in accessibility as they naturally upgrade their website, they usually spend much less—between 1% and 3%, he said.

The ADA requires equal access to "public accommodations," which include restaurants, retail stores, movie theaters, recreational facilities and other physical spaces that are spelled out by the law. It makes no mention of websites as a public accommodation.

Some courts have held that ADA covers only physical spaces. The Target case, which settled in 2008, marked the first time a federal district judge ruled that the law applies to websites when they act as a gateway to a brick-and-mortar store. As part of the settlement, Target established a $6 million fund for settlement claims and agreed to modify its website to meet accessibility guidelines. Target declined to comment.

Last June, a federal district judge in Massachusetts became the first to rule that the ADA's accessibility requirements apply to website-only businesses. The case involved a suit brought by the National Association of the Deaf against Netflix. It demanded the company provide closed captioning for its Internet video subscribers.

"The fact that the ADA does not include Web-based services as a specific example of a public accommodation is irrelevant," wrote Judge Michael Ponsor. The legislative history of the ADA, he wrote, made it clear that Congress intended the law to adapt to technology.

After the ruling, Netflix agreed to make 100% of its content captioned by 2014. The company declined to comment.

Howard A. Rosenblum, CEO of the National Association of the Deaf, said his group was in discussions with other companies about captioning streaming movies online. "Legal action will be taken where such discussions are not successful," Mr. Rosenblum wrote in an email.

Most cases are resolved without litigation, said Lainey Feingold, a California lawyer who specializes in Web accessibility.

She has reached 45 agreements in the past 18 years with companies ranging from Bank of America Corp.
to Charles Schwab. She credited the financial industry, in particular, for its efforts to improve website accessibility.

Robert Fine, a Miami-based lawyer who represents companies in ADA matters, said clients are increasingly seeking counsel on website accessibility before they are approached by lawyers such as Ms. Feingold, because they want to avoid bad publicity and increase their market share.

"My clients tend not to be saying 'How do I get out of doing this,' " he said.

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